What is the only host response modulator that is approved?
sub-antimicrobial dose doxycycline
Proinflam mediators such as prostaglandins and cytokines are balanced by
anti-inflam cytokines and lipoxins
Destructive activites of MMPs are balanced by their
inhibitors, the tissue inhibitors of metalloproteinases
PGE1 is a key inflam mediator as it upregulates
osteoclastic bone resorption
PGE2 is produced by a variety of resident and infiltrating cell types in the periodontium in response to
lipopolysaccharide
NSAIDs inhibit the formation of prostaglandins by blocking the
COX pathway of arachidonic acid metabolism
What are disadvantages of NSAIDs?
- Long term use is needed
- Significant side effects
- Rebound bone loss after cessation
Preliminary studies in animals showed that selective COX-2 inhibitors slowed
alveolar bone loss
Human studies confirmed that prostaglandin production in the periodontal tissue was
modified
Bisphosphonates disrupt
osteoclastic activity and thereby inhibit bone resorption
Bisphosphonates posess
anticollagenase properties
In human studies, bisphosphonates _______ alveolar bone density
increased
What is the half life of bisphosphonates?
10yrs
What is the sub-antimicrobial dose of doxy used for host modulation?
20mg twice daily for 3 months up to 9 months
What is the MOA of doxycycline for host modulation?
Downregulates activity of MMPs by a variety of syndergistic mechanisms including reductions in cytokine levels and stimulates osteoblastic activity
